类风湿关节炎滑膜中高迁移率族蛋白1的表达

Expressions of high mobility group box chromosomal protein 1 in synovial membranes in patients with rheumatoid arthritis

目的探讨高迁移率族蛋白1(HMGB1)与类风湿关节炎(RA)发生和发展的关系。方法采用免疫组织化学方法观察25例RA和3例未累及关节的创伤患者滑膜中HMGB1的表达规律与分布特点及与血清急性时相反应蛋白的关系。结果22例RA滑膜HMGB1标记阳性,RA滑膜中滑膜上皮细胞和血管内皮细胞呈阳性反应,其中以巨噬细胞样滑膜细胞为多,另有部分成纤维细胞样滑膜细胞。RA滑膜中HMGB1细胞内分布以细胞质中表达较多,细胞核中无表达或表达较少,与正常滑膜中HMGB1主要在细胞核中表达有明显的不同。RA滑膜上皮细胞HMGB1标记阳性细胞百分比与RA患者血清C反应蛋白无显著相关(rs=0.372,rs0.05=0.381)。结论RA滑膜中核外HMGB1的出现,作为晚期炎症因子参与了RA的疾病过程,可能在RA组织损伤的病理过程中起重要作用。

Objective To investigate the relationship between the change of high mobility group box chromosomal protein 1 （HMGB1） and the pathogenesis of rheumatoid arthritis （RA）. Methods The expression and distribution of HMGB1 on synovial membranes were examined by immunohistochemical method and the acute phase reactive proteins in serum were also measured in 25 patients with RA. Three traumatic patients without joint involvement were used as control group. Results The positive staining of HMGB1-in synovial membranes were found in 22 of 25 patients with RA. The HMGB1 positive cells in the synovial membranes of patients with RA were synovium epithelial ecll, vascular endothelial cells and inflammatory cells, including macrophage-like synovial cells and fibroblast-like synovial cells. It also showed that HMGB1-1 in RA synovial membranes was confined to the cytoplasm, with occasional expression in nucleus. In contrast, a distinctly different HMGB-1 staining pattern was observed in the normal synovial membrane. There was no significant association between the ratio of positive stained cells and serum C-reactive protein （rs=0.372, rs0.05=0.381）. Conclusion HMGB1, which appears in the extranucleus of synovicytes and acts as a potent cause of inflammation, may play pivotal roles in the pathogenesis of arthritis.